Individual
ELIAS SIRAG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12841 HAWTHORNE BLVD, HAWTHORNE, CA 90250-4413
(323) 535-8561
Mailing address
14135 CERISE AVE APT 314, HAWTHORNE, CA 90250-8497
(323) 535-8561
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
—
Other
Enumeration date
11/06/2023
Last updated
01/14/2024
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